Carter BloodCare Service Manual

 
 
 
 
 

1.1         History
1.2         Mission Statement
1.3         Vision Statement
1.4         Accreditation
1.5         Department Descriptions and Contact Directory
1.6         Forms
                  Bedford Organizational Chart
                  Tyler Organizational Chart


 
 

2.1         Quality Policy Statement
2.2         Quarantine Notices
2.2.1      Quarantine/Lookback Notices
2.3         Recall/Market Withdrawal Notices
2.4         Quality Assurance Consultation Services
2.5         Forms
                  QAF403.01 Suspected Component Contamination Notification
                  QAF601.01A Component Recall/Market Withdrawal Notification
                  QAF601.01B Quarantine-Release Notification
                  QAF602.01 Consignee Notification Record            
                  QAF602.01.01 Reactive Non-Discriminate Multiplex HIV-1/HCV Assay Notification


 
 

3.1         Disaster Plan
         3.1.1    Coordinating the Local Blood Supply During Disasters
                  3.1.1.1  Purpose
                  3.1.1.2  Introduction
         3.1.2     Glossary of Terms
         3.1.3     Carter BloodCare’s Responsibilities
         3.1.4     Customer’s Responsibilities
                  3.1.4.1  Pre-Disaster Preparation Checklist
                  3.1.4.2  During the Disaster
                  3.1.4.3  Working with the Media
         3.1.5     Biological Attack Response Process
         3.1.6     Regulatory Concerns
         3.1.7     Handling Internal Disasters at Carter BloodCare
3.2         Blood Service Agreement Statement
3.3         Finance and Billing Policies
         3.3.1     Third Party Payments
         3.3.2     Payment Options
         3.3.3     Billing Periods
         3.3.4     Payment Terms
         3.3.5     Billing Transaction Document
         3.3.6     Weekly Invoices
         3.3.7     Credit Memo
         3.3.8     Debit Memo
         3.3.9     Return Slip
         3.3.10     Transfer Slip
         3.3.11     Pack List
         3.3.12     Financial Questions
3.4         Notification of Policy Changes
3.5         Forms
                  Weekly Invoice
                  Credit Memo
                  Debit Memo
                  Return Slip
                  Transfer Slip
                  Pack List


 
 

4.1         Reporting Adverse Reactions
         4.1.1     Definition
         4.1.2     Types of Adverse Transfusion Reactions
         4.1.3     Transfusion Related Fatalities
         4.1.4     Reporting a Suspected Transfusion Reaction
         4.1.5     Recommended Actions if a Suspected Transfusion Reaction Occurs
         4.1.6     To Initiate a Transfusion Reaction Investigation Work-up
         4.1.7     Carter BloodCare Transfusion Reaction Investigation
4.2         Suspected Cases of Transfusion-Associated Infection
         4.2.1     Notification to Carter BloodCare
         4.2.2     Other Notification
         4.2.3     Carter BloodCare Investigation
4.3         Reporting Transfusion Related Lung Injury (TRALI)
4.4         Forms
                  RTF195.03B, Transfusion Reaction Investigation Final Report
                  RTF215.01A, Transfusion Reaction Investigation
                  RTF195.03A, Transfusion Reaction Preliminary Report
                  DNF106.02A, Report of Suspected Transfusion Associated Infection
                  DNF106.30A, Report of Transfusion-Related Acute Lung Injury Investigation
                  DNF106.30D; Suspected TRALI Investigation Summary


 
 

5.1         General Customer Complaints, Comments, and Customer Incidents
5.2         Customer Surveys
5.3         Forms

QSF702.01, Customer Incident


 
 

6.1         Circular of Information
6.2         Supplies


 
 

7.1         Neighborhood Donor Centers
7.2         Blood Drive Information
7.3         Health Fairs


 
 

8.1         Autologous Donations
         8.1.1     Autologous Blood Donation Request
         8.1.2     Autologous  Donation Criteria
         8.1.3     Autologous Donation Scheduling
         8.1.4     Facility Notification of Autologous Donation
         8.1.5     Autologous Labeling
         8.1.6     Low Weight/Volume Autologous Red Cells
         8.1.7     Autologous Unit Testing
         8.1.8     Special Considerations
         8.1.9     Policy for Freezing Autologous Red Blood Cells
8.2         Restricted Donations
8.3         Therapeutic Phlebotomy
         8.3.1     Therapeutic Donor Request
         8.3.2     Therapeutic Donation Criteria
         8.3.3     Therapeutic Phlebotomy Scheduling
         8.3.4     Associated Fees
         8.3.5     Unit Disposition
8.4         Hereditary Hemochromatosis (HH) and Low Testosterone (LOT) Therapy
         8.4.1     Donor Meets Eligibility Criteria and has a Draw Frequency of >8 Weeks
         8.4.2     Donor Does not meet Eligibility Criteria &/or Requires a Draw Frequency of <8 weeks
8.5         Forms
         8.5.1   Autologous Forms
                  SDF801.01, Autologous Blood Donation Request
                  SDF801.01B, Autologous Worksheet
                  SDF801.01C, Donation Attempt Notification Letter to Hospital
                  SDF802.01A, Autologous Blood with Abnormal Test Result Notification
                  SDF801.01E, Frozen Autologous Red Blood Cell - Management Record
                  DCL255, Autologous Tie Tag (double sided)
                  Autologous Donation Information
         8.5.2   Restricted, Therapeutic, HH and TRT Forms
                  DCL500, Restricted Donation tie tag (orange)
                 SDF801.03 Therapeutic Donor Request
                  Therapeutic Donation Information Sheet
                  DNF104.35C Enrollment/Prescription for No-Fee Phlebotomy for Hereditary Hemochromatosis (HH) Patients Only
                  DNF104.35D Enrollment/Prescription for Phlebotomy Due to Testosterone Replacement Therapy (TRT)


 
 

9.1         Components Provided
9.2         Component Manipulation Services
9.3         Donor Unit Testing
         9.3.1     Routine Testing
         9.3.2     Other Tests Performed as Indicated
9.4         Testing and Labeling
9.5         Placing an Order
9.6         Specimen Collection and Preparation
9.7         Unacceptable Specimens
9.8         Specimen Shipping
         9.8.1    Sample Shipping Requirements
         9.8.2    Sample Delivery
9.9         Test Turn-Around-Time (TAT)
9.10      Test Cancellation
9.11      Results and Reports
9.12      Forms
                  Remote Testing Requisition Form (4 part/carbonless)
                  Carter BloodCare Platelet Apheresis Tag
9.13      Acceptable Plasma Examples


 
 

 
 

11.1      Placing an Order
         11.1.1     Phoned Orders
         11.1.2     Faxed Orders
         11.1.3     iWebb Orders
11.2      Order Confirmation
11.3      Order Status
         11.3.1     STAT
         11.3.2     Urgent
         11.3.3     ASAP (As Soon as Possible)
         11.3.4   Routine
         11.3.5   Hospital to Hospital Transfer
11.4      Delivery Response Times
11.5      Filling an Order
11.6      Delivery Options
11.7      Product Substitution
11.8      Emergency Release
11.9      Inventory Management
11.10   Order Documentation
11.11   Return Policy and Quarantine Requests
11.12   Forms
                  DPF200.20A, Fax order and Inventory Form
                  DPF300.03, Hospital Report of Returned Blood Components
                  DPF200.05, Hand Ship Ticket
                  DPF300.03A, Return of Blood For Investigation
                  DPF400.20A, Quarantine Request Facsimile
                  DPF400.20B, Quarantine Release Request Facsimile
                  DPF400.20C; Notification/Quarantine Request Fax


 
 

12.1      General Information for Patient/Reference Testing Services
         12.1.1      Contract
         12.1.2      Requisitions
         12.1.3      Specimen Collection and Preparation
         12.1.4      Sample Shipping Requirements
         12.1.5      Unacceptable Specimens
         12.1.6      Available Tests
         12.1.7      Test Priority (Does Not Include Delivery Time)
         12.1.8      Test Cancellation
         12.1.9      Results, Reports, Requests for Quarantine, and Requests for Historical Patient Antibody Testing Information 
         12.1.10  Emergency Release of Untested Components
         12.1.11  Notification of Pending Test Completion
12.2      Reference Testing Services – Red Blood Cells
         12.2.1     Serological Testing
         12.2.2     Red Blood Cell Antigen Screening
         12.2.3     Red Blood Cell Crossmatch Services
12.3      Reference Testing Services – Platelets
         12.3.1     HLA matching
         12.3.2     Platelet Antibody Screening and Crossmatching
         12.3.3     Requesting Platelet Testing Services
         12.3.4     Sample Requirements for Platelet Testing Services
         12.3.5     Platelet Labeling
12.4       Reference Testing Services – Molecular Testing Services
12.5       Reference Testing Services – Preventative Maintenance Services
12.6       Reference Testing Services – Cellular Therapy Services
12.7      Granulocyte Product Order
12.8      Example Reports
12.9      Forms
                  APL100, Apheresis Product Tag
                  APL100, Crossmatched Apheresis Product Tag
                  RAF601.00, Request for Product Quarantine, Records Audit and Data Entry
                  RTF101.01A, Reference and Transfusion Services Request Form
                  RTF103.01A, Reference and Transfusion Service Patient Historical Record - Bedford
                  RTF120.11A, Request for Product Quarantine, Discard, or Retrieval
                  RTF120.11D Reference and Transfusion Suspected Component Contamination Notification
                  RTF214.01, Uncrossmatched Product Release
                  RTF214.03, Untested Product Release form
                  RTL214.01, Emergency Release Uncrossmatched Blood Label
                  RTL214.03A, Previous Donation Results Label
                  RTL214.03B, Testing Not Performed Label
                  RTL422.01, HLA Matched Tie Tag
                  Non-Crossmatch Compatibility Tag
                  Crossmatch Compatibility Tag
                  RTL207.01A, Confirmed Antigen Typing
                  RTL207.01C, Molecular Matched Antigen Typing
                  RTF101.01F Flow Cytometry Cellular Therapy Request
                  RTF205.13A Granulocyte Product Order & Physician Release Form


 
 

13.1      Therapeutic Apheresis Services
13.2      Diseases which may be treated by Apheresis
13.3      Contract/Privileges
13.4      Emergency Privileges
13.5     Granulocyte Orders


 
 

14.1      Overview
14.2      Contract/Privileges
14.3      Emergency Privileges
14.4      Product Collection, Processing, and Infusion
         14.4.1     Collections of Peripheral Blood Stem Cells
         14.4.2     Institutional Responsibilities for PBSC Collection
         14.4.3     Donor Prescreen for PBSC and Marrow Collection
         14.4.4     Assisting with Surgical Harvest of Bone Marrow
         14.4.5     Processing and Cryopreservation
         14.4.6     Product Storage
         14.4.7     Thawing and Infusion
14.5      Forms
                  HPF170.06, Infectious Disease Tube Collection Form


 
 

15.1      Suggested Services


 
 

16.1      Carter BloodCare Tours
16.2      Hospital Forums
16.3      Staff In-services
16.4      External Audits Performed for Transfusion Services
16.5      Known Samples Provided
16.6      Reimbursement Review for Blood Product Coding
16.7      Transfusion Medicine Fellowship Rotation
16.8      Resident Pathologist Blood Center Rotation
16.9      Medical Student Blood Center Community visits